Individual provider Active NPI

Jerry Chan-Hsiang Chih, MD

  • Pediatrics Physician
  • Pembroke Pines, FL
National Provider Identifier
1003303330
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME166665 Issued in FL
Practice address
400 N Hiatus Rd Ste 105
Pembroke Pines, FL 33026-5214
Phone
(954) 431-8000
Fax
(954) 436-0449
NPI assigned
Apr 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 63266 TN
Pediatrics Physician 208000000X ME166665 FL Primary

Addresses

Primary practice location

400 N Hiatus Rd Ste 105
Pembroke Pines, FL 33026-5214

Mailing address

900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (954) 431-8000

Other identifiers 1

IdentifierTypeStateIssuer
122776800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME166665FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC Pediatrics PastSince Nov 10, 2024 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson Pediatrics PastSince Jul 1, 2024 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC Pediatrics PastSince Jul 1, 2024 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1003303330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "954-431-8000",
            "fax_number": "954-436-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N HIATUS RD STE 105",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265214",
            "telephone_number": "954-431-8000",
            "fax_number": "954-436-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIH",
        "first_name": "JERRY",
        "middle_name": "CHAN-HSIANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-23",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "63266",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME166665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122776800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.